Comprehensive assessment of primary and secondary low bone mass using Dual-Energy X-ray Absorptiometry and Cone Beam Computed Tomography-a cross-sectional study.

Abstract

Objective: The present study examined the potential use of computed tomography panoramic mandibular indices on cone beam CT (CBCT) for the assessment of bone density in patients with primary and secondary causes of low bone mass.

Study design: The study enrolled 104 postmenopausal women and 66 patients with endocrine-related low bone mass (diabetes mellitus, acromegaly, Cushing's syndrome), who underwent dual-energy X-ray absorptiometry (DXA) and CBCT scanning. The study assessed the correlation between DXA parameters (lumbar spine, femoral neck, and total hip T-score, bone mineral density (BMD), and trabecular bone score (TBS)) and CBCT-derived indices (CT mandibular index superior (CTI(S)), CT mandibular index inferior (CTI(I)), and CT mental index (CTMI)).

Results: Significant correlations were found between the CBCT indices and both quantitative (BMD, T-score) and qualitative (TBS) measures of bone mass. In postmenopausal women, all three CBCT indices showed strong correlations with DXA parameters. In secondary endocrine causes, CTMI and CTI(S) were significantly correlated with TBS scores, and CTMI also showed a significant correlation with lumbar BMD.

Conclusion: The study concludes that CTI(S), CTI(I), and CTMI are valuable for assessing bone density and quality in patients with low bone mass, both in primary and secondary osteoporosis related to diabetes mellitus, acromegaly, and Cushing's syndrome.

Advances in knowledge: These findings support the use of CBCT as a useful tool for evaluating bone health in the clinical setting and optimizing dental implant result. It's among the first studies to evaluate bone mass quality and quantity in secondary endocrine causes of low bone mass.